Clinical Pharmacist – Diabetes Transition Spartanburg Regional Medical Center Spartanburg, South Carolina, United States
Key Takeaways of Your Research: The pilot project was designed to determine safety and efficacy of insulin glargine as a once-daily or twice-daily regimen for the non-critically ill population. At a single health care system, there was no difference between insulin glargine once-daily and twice-daily regimens. Additional research should be completed to determine the appropriate dosing of insulin glargine in the inpatient setting, specifically based on person-related factors and characteristics.
Background/Purpose: Insulin is the treatment of choice for inpatient diabetes management. There is limited evidence on the safety and efficacy of once-daily versus twice-daily insulin glargine in the hospital. The purpose of this pilot study was to compare the efficacy and safety of insulin glargine administered as a once-daily versus twice-daily regimen in non-critically ill people. Research Hypothesis and/or Research Questions and Specific
Aims: Is there a difference in efficacy and safety when insulin glargine is given once daily versus twice daily? Methods/Methodology: This study was a retrospective chart review from June 1, 2020, to May 31, 2021. Inclusion criteria included people over 18 years old and had received once-daily or twice-daily insulin glargine for at least 72 hours. The primary endpoint was comparison of the number of days that all blood glucose measurements were 70-180 mg/dL over a 24-hour period (000-2359).
Results: Group 1 included participants who received insulin glargine as once-daily regimen (n=101), whereas Group 2 were participants who received the basal insulin as twice-daily regimen (n=103). Baseline characteristics were similar in both groups except for higher BMI at admission (p=0.01) and higher pre-admission A1c (p=0.02) in Group 2. No differences were found between the two groups for the primary outcome (p=0.5) or the secondary outcomes of number of hypoglycemic (p=0.6) and hyperglycemic events (p=0.7).Conclusions (Impact on Diabetes Care and Education): There was no significant difference in the efficacy or safety of insulin glargine given as a once-daily versus twice-daily regimen in the non-critically ill population. This project was a retrospective pilot study with a small sample size so further research may be required to confirm these results in the inpatient setting. Source of Funding for this Research: None
